The rise of medical weight management in aesthetics
The rapid rise of medical weight loss in aesthetics, the surge in GLP-1 demand, and what this means for safe, ethical practice.
Weight loss has long been one of the most emotionally charged and commercially influential areas of healthcare. While many aesthetic clinics have offered treatments for body shaping and fat reduction, the rise of GLP-1 receptor agonists has brought weight management rapidly to the forefront in the aesthetics space. Whether it's providing the services in clinic or dealing with the after effects of rapid weight loss, the aesthetics sector is very closely linked to this growing trend.
Demand for drugs such as semaglutide and tirzepatide has exploded across the UK, with recent reports suggesting that around 2.5 million people are now using weight loss jabs, a seven-fold increase compared with the same period last year, with uptake accelerating month on month.
Surveys also indicate that 11% of UK adults are currently using a weight-loss medication, 8% intend to start, and an additional 16% are interested but want more information.
Despite Government plans to expand NHS availability, private use far outweighs NHS access. More than 90% of users obtain these medicines privately, with online providers accounting for around 80% of purchases.
Mounjaro (tirzepatide) is thought to be the most popular option used in the UK, followed by Wegovy. Market volume has climbed steadily since 2024, with an average 24.6% monthly increase in prescriptions.
This surge is happening against a backdrop of significant public health needs. According to the House of Commons Library, 26% of adults in England are living with obesity, and a further 38% are overweight – figures that continue to rise year on year.
These statistics partly explain why patients are turning to medical interventions, but they also highlight why weight management must be approached as a clinical, not cosmetic, service.
In addition, the rapid commercialisation of weight loss medications has created new concerns.
Counterfeit pens, online sellers, and non-medically trained providers have contributed to a rise in complications and governance gaps, as highlighted by professional bodies and insurance providers, including Hamilton Fraser. We explore this in more detail in Chapter 2.
GLP-1 receptor agonists form part of a class of medications originally developed for type 2 diabetes.
They work by mimicking naturally occurring hormones released by the gut, primarily glucagon-like peptide-1 (GLP-1), and in the case of newer agents like tirzepatide, glucose-dependent insulinotropic polypeptide (GIP) as well.
These hormones play a central role in appetite regulation, digestion and metabolic control.
GLP-1 acts directly on the appetite-control centres in the hypothalamus. When these receptors are activated, patients experience:
Reduced hunger
Earlier and more sustained feelings of fullness
Fewer cravings
Decreased reward-driven eating
This has a meaningful behavioural impact, helping patients naturally lower their calorie intake without restrictive dieting.
These medications slow the rate at which food leaves the stomach, which:
Prolongs satiety after meals
Smooths post-meal blood-sugar spikes
Reduces the urge to snack between meals
This mechanism is partly why some patients experience nausea when starting treatment—it is a predictable pharmacological effect of delayed gastric emptying.
GLP-1 and GIP both stimulate insulin release in a glucose-dependent manner, meaning the drugs support blood-sugar regulation only when needed. They also:
Reduce inappropriate glucagon release
Improve insulin sensitivity
Moderate glycaemic peaks and troughs
While this is essential for patients with type 2 diabetes, it also contributes to steadier energy levels and reduced hunger signals in non-diabetic patients.
• Semaglutide (Wegovy/Ozempic)A GLP-1 receptor agonist that enhances satiety and improves insulin control.
Wegovy is licensed for obesity.
Ozempic is licensed for type 2 diabetes but has been widely used off-label for weight loss.
• Tirzepatide (Mounjaro)A dual-agonist of both GLP-1 and GIP receptors, producing sharper appetite suppression, enhanced metabolic effects and greater average weight loss than semaglutide.
Now licensed for both weight loss and type 2 diabetes.
Clinical trials show average weight-loss results of 15% and above, with some patients achieving reductions over 20% – a dramatic advance compared with historic targets, where 5% was considered clinically meaningful.
These medications are not intended for cosmetic weight loss or for patients seeking rapid results without lifestyle support; however, we are seeing them widely used as such.
They are most effective when combined with nutritional guidance, physical activity and behaviour change (see Chapter 3).
Licensed prescribing criteria usually include:
BMI ≥ 30 (obesity)
BMI ≥ 27 with at least one weight-related co-morbidity, such as:
Hypertension
Dyslipidaemia
Type 2 diabetes
Obstructive sleep apnoea
You can read the Government guidance here.
Aesthetic healthcare professionals with prescribing authority and clinical oversight are well placed to offer weight-management support, but only when supported by robust governance, patient selection protocols, and clear treatment pathways.
Education is central: patients must understand that medications are not shortcuts but tools that work best when paired with behavioural change, nutritional support and physical activity.
Hamilton Fraser recently recorded a podcast with independent prescriber Piroska Cavell, who has a postgraduate diploma in Obesity and Weight Management.
She says, “If we can encourage people to be healthier that is important but we have to be mindful of is those people who are going to want to try and achieve this idea of perfectionism with using weight loss medications.
My concern is that, with the best will in the world, lots of clinics/practitioners don't understand obesity and weight management at a cellular/biological level."
Key takeaway: The rapid growth of GLP-1 use highlights the need for clear clinical guidance and responsible integration of weight-loss medicines within aesthetic practice.
